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07/29/2003 16:15 4640138 ENVIRONMENTAL HEALTH FAGS 01 <br /> uAl t rtd.q,reu <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN ^, <br /> 204 EAST WEBER AVENUE,TMIRD FLOOR <br /> U 1 0 0 2003 �0I' $TOCKTON CA 96702 <br /> - k,+01,3$ (209)499-3421) I I <br /> P'9LIC RECORDS RELEASE, APPLICA-n <br /> y h7r1�A � C�oa LS/3� _ BU6INESSMGENCI' ! <br /> APPLICANT <br /> T ADDRESS�''�733� L///���i=/i o�/. %'•9/�K �/f.,Sio �/,�r/E/Son��%/j/f, C.J 9S65�Z <br /> PHONE [,[� 713 _ Z�6 y FACSIMILE Sia- 6 6 00 5 <br /> TENTATIVE"APPOINTMENT DATE TIME <br /> (Please gyve 7 to 10 bua1nae9 days from data of appiltwen BubMittal) <br /> CHECK BOX To EXPEDITE REQUEST,689.00^F-E£-REQUEST PROCP83FD IN a 9U91NESS nAYS <br /> -*SIGNATURE OF APPLICANT �� �v� � DATE! <br /> THIS SIDE%MD STAFF USE ONLY <br /> FILE ADDRESS PROGtxA1a ELEMENTS SEARCH <br /> �V SbOp S4dtN 14/11414, Q <br /> F l <br /> or <br /> MISR <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> kq.UNDERGROUND TANK(u"CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SrrE(NON-LOP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> f2f'UNDERGROUND TANK IMONITORINO!REMOVAL) ❑ 1306 KENNEL ❑ DAIRY <br /> q HAZARDOUS WASTE.GENERATOR O CHICKEN RANCH 13PK6 TREATMENT PLANT 'I <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTPL i7l PUMPER TRUCIVYARDTCHEM TOILE7$ <br /> ❑ TATTOOMGCIY PEIRCtNG ❑ POOLISPA ❑ LAND USE APPLICATION eRES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIF`n <br /> 1. List up to ten addresses in the space above. Select the types) of files from the list above by checking <br /> the appropriate hox(es), At least one file type MUST be selected. Fax to (Zn 484AI38 or mail to the <br /> add ani i Icated d_coq <br /> 2, EHD will notify the applicant if any END 6199 exist An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10)days after receipt of appllcallion,-The tiles <br /> will be held for a maximum of five business days for review. Appointments should be soheduled <br /> accordingly. <br /> 3, A file that is actively baing worlmd on by EHD staff may not be immediately available for review, A new <br /> application may be Submitted when the file Jr.available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the game applicant may require a$69,00 deposit prior to review. <br /> S. "TENTATIVE appointment dates must be confirmed with RHD staff. <br /> 6. Applications received after 3:00 pm will he processed the next business day. <br /> CONFIRMED APPOINTMENT DATE __ TIME ---------- <br /> 0 1 ATt <br /> _DATE CONFIRMED PHDNE PAX IN} _ s � <br /> REVIEWED YF,$ NO REVIEW DATE <br /> EMC19-0 1` <br /> �rmaaro <br />